Endoscopic Management of Chronic Pancreatitis in Children: A Single-center Experience Over a Decade

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BACKGROUND: Chronic pancreatitis (CP) complications in adults are successfully managed with endoscopic retrograde cholangiopancreatography (ERCP). Data are limited on the success of ERCP in children with CP. We reviewed our experience to ascertain the success, safety, and effectiveness of ERCP for relieving pain and its effect on exocrine and endocrine insufficiency. METHODS: Retrospective analysis of a prospectively kept database of children (≤18 y) with CP who underwent therapeutic ERCP between 2010 and 2020 was reviewed. Clinical details, laboratory and radiologic investigations, procedural details, and follow-up data were retrieved from manual and electronic records. Categorical and numerical data were expressed as proportion and mean ± SD. RESULTS: Sixty-five children (60% males), age 12.8 ± 2.9years, were included. The most common etiology was idiopathic (n = 45, 69%). Technical, endoscopic, and clinical success rates were 95.3%, 92.3%, and 85.6%, respectively. Only 4 patients (6.1%) had major complications. Over a median follow-up of 24 months, therapeutic ERCP resulted in significant pain relief, with nonprogression of exocrine and endocrine insufficiency. Recurrence of symptoms was noted in 10%, which were managed successfully with repeat ERCP. CONCLUSION: Therapeutic ERCP is a safe and effective therapy for the management of CP in children, with significant improvement in pain, and could influence stabilization of exocrine and endocrine functions.

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